Paxil Frequently Asked Questions
- What is Paxil?
- How does Paxil work?
- What are the Paxil side effects?
- What is Akathisia?
- What is depression?
- What is Anxiety Disorder?
- What is Social Anxiety Disorder?
- What is Obsessive-Compulsive Disorder?
- What is Post Traumatic Stress Symdrome?
- What are the symptoms of Post Traumatic Stress Syndrome?
Paxil (paroxetine hydrochloride) is an antidepressant medication that is part of a family of drugs called selective serotonin re-uptake inhibitors (SSRIs). Paxil is sold as Seroxat outside of the United States and as PaxilŽ (paroxetine HCl) in the United States.
Paxil is currently approved by the Food and Drug Administration (FDA) for the treatment of major depressive disorder, generalized anxiety disorder (GAD), social anxiety disorder (SAD), panic disorder, obsessive-compulsive disorder (OCD) and posttraumatic stress disorder (PTSD) in adults. Recently, GlaxoSmithKline PLC applied to the Food & Drug Administration for permission to market Paxil as an effective treatment for acute social phobia, an extreme form of shyness.
Paxil is available in tablet and liquid form. Paxil liquid is orange-flavored and orange-colored. Each 5 mL dose contains the equivalent of 10 mg of Paxil. The liquid should be shaken well before using, and stored at or below 77°F (25°C). Paxil tablets are oval-shaped and film-coated to make swallowing easier. They are available in various strengths, and come in different colors according to their strength.
- Yellow: 10 mg, marked on the front with "PAXIL," on the back with "10."
- Pink: 20 mg, marked on the front with "PAXIL," on the back with "20."
- Blue: 30 mg, marked on the front with "PAXIL," on the back with "30."
- Green: 40 mg, marked on the front with "PAXIL," on the back with "40."
Depression and anxiety disorders are believed to be caused by a chemical imbalance in the brain. One of these chemicals is serotonin, which helps send electrical signals from one nerve cell to another. In the process, serotonin is released from the sending nerve sell and travels to the receiving one where it is either absorbed or returns to the original sender cell.
According to SmithKlineGlaxo, the manufacturer of Paxil, when a person suffers from depression or anxiety disorders, it typically indicates a problem with the serontonin balance and its effect on cell-to-cell communication-too much serotonin is reabsorbed by the first nerve cell, so the next cell does not have enough. To paraphrase, it's similar to a conversation where one person does all the talking and the other person never gets to talk, leading to a communication imbalance.
Paxil blocks serotonin from being reabsorbed back into the sender nerve cell, which increases the amount of serontonin available to be absorbed by the receiver cell and can help the cell-to-cell message transmission and communication return to normal.
What are the Paxil side effects?
Common side effects include:
- headache;
- tremor, nervousness, or anxiety;
- urinary retention, constipation;
- tachycardia (sudden, rapid racing of the heart);
- profuse sweating;
- postural hypotension (decrease in blood pressure when you sit or stand);
- nausea, diarrhea, dry mouth, or changes in appetite or weight;
- sleepiness or insomnia;
- sexual side effects like decreased libido (sex drive), impotence; and
- social dysfunction.
Paxil is also associated with withdrawal symptoms that could occur when dosages are dramatically decreased or patients are discontinuing treatment. It is estimated that approximately four to ten percent of Paxil users will experience extreme adverse Paxil withdrawal symptoms, though others may experience more mild Paxil withdrawal symptoms. The onset of Paxil withdrawal symptoms usually occurs between one to three days following the discontinuation of treatment and can last for many months in more severe cases. A period of two to six weeks is the average time patients experience Paxil withdrawal symptoms. For some people, the symptoms of Paxil withdrawal are among the most horrifying experiences imaginable. The following are some of the more mild symptoms:
- Dizziness, extreme nausea, crying spells, light headedness
- Vertigo, coordination problems, gait disturbance, sweating, vomiting
- High fever, abdominal discomfort, flu symptoms, agitation,
- Irritability, aggression, sleep disturbance, nightmares, tremor
- Confusion, lethargy, malaise, weakness, general fatigue
- Memory & concentration difficulties, intense insomnia, extremely vivid dreams
- Extreme confusion during waking hours, fear of losing your sanity
- Depersonalization, feeling of existing outside of reality, panic attacks
- Memory and concentration problems, suicidal thoughts, dizziness/vertigo
- Severe mood swings, extreme irritability and anger, unsteady gait
- Electric feeling shocks throughout your body, slurred speech, headaches
- Profuse sweating, muscle cramping, blurred vision, decreased appetite
- Outbursts of tears for no apparent reason, nausea, abdominal cramping hypersensitivity to motion, sounds, smells, loss of appetite, chills/hot flashes
Some of the more severe symptoms can include, but are not limited to: extreme mania possibly involving delusions and hallucinations, the paradoxical effect of causing or making depression worse, intense anxiety and agitation, the development of compulsions and obsessions, and akathisia. Akathisia causes extreme agitation, discomfort and loss of motor control and is considered to be one precursor to the hostile, violent, suicidal and homicidal behaviors that occur with both Paxil use and Paxil withdrawal symptoms. There may be other withdrawal symptoms in addition to those listed here. See a doctor immediately.
If you are diagnosed as suffering from withdrawals that may be linked with your use of Paxil, contact a Paxil lawyer now. If you are taking monoamine oxidase inhibitors (MAOI) such as isocarboxazid (Marplan), phenelzine (Nardil), or tranylcypromine (Parnate) during the last 2 weeks, or if you take thioridazines you should not take Paxil.
Akathisia refers to the peculiar state of mental and motor restlessness that cause a state of "inner agitation." A person suffering from Akathisia is acutely aware of the strong desire to be in a restless state of constant motion, but he or she cannot voluntarily suppress the desire. In its milder form, the patient may just appear anxious, and a physician may mistakenly diagnose it as "non-specific anxiety" if he or she is not aware of the specific clinical features of akasthisia.
In its more severe form, akathisia is associated with severe dysphoria, "prominent depressive symptoms superimposed on manic psychosis" (Merck Manual definition). Accute akathisia involves the patient feeling very fidgety with a strong urge to repeatedly change body position (e.g., the sitting patient may constantly shift his position in a chair, or make constant rocking motions, or constantly cross and uncross his legs, or constantly swing his legs to-and-fro; the standing patient may constantly shift from one foot to the other foot, and he or she may even frantically pace about the room). The marked distress associated with akathisia can lead to impulsive suicide attempts. Akathisia is commonly associated with antipsychotic medications, as well as various antidepressants, including tricyclics and selective serotonin reuptake inhibitors (SSRIs) like Paxil.
It is estimated that 19 million Americans suffer from depression every year. Depression is not a weakness or a character flaw-it is an actual medical illness leading to intense feelings of sadness or despair. The reasons for depression are not always clear. It may be spawned by an event like including traumatic life experiences such as the death of a loved one, certain diseases or taking medications, substance abuse or hormonal changes. Or, it may happen for no apparent reason at all. Sometimes, people are genetically predisposed to depression due to a family history of the genes not providing the brain with enough serotonin. The symptoms of depression may differ from person to person. Some symptoms may include a persistent sad mood, lack of pleasure in activities, change in sleep or eating habits, or a feeling of worthlessness.
Whatever the circumstances, depression is caused by an imbalance of certain chemicals in the brain. Normally, these "chemical messengers" help nerve cells communicate with one another by sending and receiving messages, and they may also influence a person's mood. In the case of depression, the available supply of the chemical messengers is low, so nerve cells can't communicate effectively. This often results in symptoms of depression.
Generalized Anxiety Disorder (GAD) is a medical illness that requires attention from a qualified healthcare professional. It involves intense feelings of being overpowered by anxiety, characterized by excessive worry, anxiety and tension, often without an apparent cause. Similar to other medical diseases like heart disease or diabetes, the exact causes of Generalized Anxiety Disorder are difficult to explain. However, research suggests that environmental and genetic factors (a family history of GAD) may predispose a person to developing the disorder. Experts also agree that GAD may be caused by an imbalance of certain chemicals in the brain, particularly two neurotransmitters (chemical message carriers) called dopamine and serotonin, which are believed to regulate mood and behavior.
Non-genetic forms of GAD may be caused by highly stressful events like a childhood psychological trauma, the death of a loved one, a particularly difficult divorce, losing your job or other emotionally traumatic events. Although the causes of GAD in a person are not always known, the symptoms are recognizable. Anxiety symptoms often present themselves during childhood or adolescence, but they can also begin in adulthood. People of all ages are affected by GAD, and the disorder is twice as likely to appear in women as in men. According to the National Institute of Mental Health, about 19 million Americans suffer from depression and 4 million from GAD each year.
What is Social Anxiety Disorder?
Social anxiety disorder (SAD), also known as social phobia, usually begins in adolescence and is often most severe in the late teens and the 20s. In 25% of individuals it begins in early childhood. Social Anxiety is the third largest mental health care problem in the world today. 15 million people (7% of the U.S. population) suffer from social anxiety disorder. In public places, such as work, meetings, or shopping, people with social anxiety feel that everyone is watching, staring, and judging them (even though rationally they know this isn't true). The socially anxious person can't relax and enjoy themselves in public. In fact, they can never fully relax when other people are around. It always feels like others are evaluating them, being critical of them, or judging them in some way.
Unlike some other psychological problems, social anxiety is not well understood by the general public or by medical and mental health care professionals, such as doctors, psychiatrists, psychologists, therapists, social workers, and counselors. In fact, people with social anxiety are misdiagnosed almost 90% of the time. People with social phobia come to our anxiety clinic labeled as "schizophrenic", "manic-depressive", "clinically depressed", "panic disordered", and "personality disordered", among other damaging misdiagnoses. Unfortunately, social anxiety does not come and go like some other physical and psychological problems. If you have it now, you'll have it the rest of your life.
Symptoms among sufferers of social anxiety disorder differ from individual to individual. Some people, for example, cannot write in public because they fear people are watching and their hand will shake. Others are very introverted and they find it too difficult to hold down a job. Still others have severe anxiety about eating or drinking in the presence of other people. Some people with social anxiety feel that a certain part of their body (such as the face or neck) are particularly "strange looking" and vulnerable to being stared at. Others experience a muscle spasm (usually around the neck and shoulders) and it becomes the center of their focus.
Current research shows that cognitive-behavioral therapy is highly successful in the treatment of social anxiety. Cognitive-behavioral treatment provides the methods, techniques, and strategies that come together to lessen the anxiety and make the world a much more enjoyable place for those suffering from social anxiety disorder.
What is Obsessive-Compulsive Disorder?
OCD symptoms can occur in people of all ages. It can start at any time from preschool age to adulthood (usually by age 40). In the United States, 1 out of 50 adults has Obsessive-Compulsive Disorder (OCD), and twice that many have had it at some point in their lives. OCD is a medical brain disorder that causes problems in information processing. In OCD, it is as though the brain gets stuck on a particular thought or urge and just can't let go. People with OCD often say the symptoms feel like a case of mental hiccups that won't go away.
To better understand the medical condition, we'll break it down into its two components:
- Obsessions: Obsessions are thoughts, images, or impulses that occur over and over again and feel out of your control. The person does not want to have these ideas, finds them disturbing and intrusive, and usually recognizes that they don't really make sense. People with OCD may worry excessively about dirt and germs and be obsessed with the idea that they are contaminated or may contaminate others. Or, they may worry excessively about burning down their houses and may be obsessed with the idea that they left the stove or iron on.
- Compulsions: To make their obsessions go away people with OCD typically perform compulsions. Compulsions are acts the person performs over and over again, often according to certain "rules." People with an obsession about contamination may wash constantly to the point that their hands become raw and inflamed. A person may repeatedly check that he or she has turned off the stove or iron because of an obsessive fear of burning the house down. OCD compulsions do not give the person pleasure. Rather, the rituals are performed to obtain relief from the discomfort caused by the obsessions.
The following are common obsessions and accompanying compulsions:
Common Obsessions |
Common Compulsions |
Contamination fears of germs, dirt, etc. |
Washing |
Imagining having harmed self or others |
Repeating |
Imagining losing control or aggressive urges |
Checking |
Intrusive sexual thoughts or urges |
Touching |
Excessive religious or moral doubt |
Counting |
Forbidden thoughts |
Ordering/arranging |
A need to have things |
Hoarding or saving |
A need to tell, ask, confess |
Praying |
What is Post Traumatic Stress Symdrome?
Post Traumatic Stress Syndrome (PTSD) can affect anyone at any age who has been exposed to a traumatic event where he/she experienced terror, threat (or perceived threat) to life, limb or sanity and his/her ability to cope was overwhelmed. Conservative estimates show that three to ten percent of the U.S. population has PTSD. Among people who were victims of specific traumatic experiences (war, torture, a natural disaster, an automobile accident, an airplane crash, a hostage situation, rape, sexual assault, child abuse, violent assaults, etc.), the rate of PTSD is much higher.
Most people who are exposed to a traumatic, stressful event experience some of the symptoms of PTSD in the days and weeks following exposure. Available data suggest that about 8% of men and 20% of women go on to develop PTSD, and roughly 30% of these individuals develop a chronic form that persists throughout their lifetimes.
Many sufferers of PTSD avoid treatment, but it is common for those who do seek treatment to be misdiagnosed. Because PTSD often occurs at the same time as other physiological and mental health disorders, PTSD symptoms may be masked or difficult to identify.
What are the symptoms of Post Traumatic Stress Syndrome?
People who have been exposed to traumatic experiences may notice any number of symptoms in almost any combination. The symptoms for PTSD are divided into three categories, as described below.
Intrusive Re-experience of the Trauma
People with PTSD frequently re-experience the trauma through distressing recollections. This is sometimes called a flashback, reliving experience or abreaction. The person may have intrusive pictures in his/her head about the trauma, have recurrent nightmares or may even experience hallucinations about the trauma. Intrusive symptoms sometimes cause people to lose touch with the "here and now" and react in the same fight-or-flight ways that they did when the trauma originally occurred. For example, many years later a victim of child abuse may hide trembling in a closet when feeling threatened, even if the perceived threat is not abuse-related.
Avoidance
People with PTSD work hard to avoid anything that might remind them of the traumatic experience. They may try to avoid people, places or things that are reminders, as well as numbing out emotions to avoid painful, overwhelming feelings. Numbing of thoughts and feelings in response to trauma is known as "dissociation." People with PTSD will typically use drugs or alcohol to avoid trauma-related feelings and memories.
Arousal
Symptoms of psychological and physiological arousal are very distinctive in people with PTSD. They may be very jumpy, easily startled or irritable and may have sleep disturbances like insomnia or nightmares. They may seem constantly on guard and may find it difficult to concentrate. Sometimes persons with PTSD will have panic attacks accompanied by shortness of breath and chest pain.
While many symptoms of severe Paxil withdrawal are acknowledged by its manufacturer, more serious Paxil withdrawal symptoms, such as the increased risk of suicide and violent behaviors, are still not adequately disclosed to patients whose health and very lives are at risk by taking Paxil. Are you a victim? Have you suffered distressing withdrawal symptoms or have you otherwise been injured by the drug? Click the panels on this page to contact a Paxil attorney and find out what your legal rights are.